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ketones in urine

(26 Posts)
juju283 Tue 31-Dec-13 10:03:46

I had a hospital appointment a week ago and was told I had ++++ketones. After researching this Ive scared myself stupid as read it can cause baby to have learning difficulties and lower iq. I am now petrified I have hurt my poor baby. I still keep getting positive results over the lasy week but as trace or +1. I'm just so worried. Was wondering if anyone else had this problem, at what point in pregnancy, how you rectified it and was your baby okay? I was told it was dehydration but my gp seemed to think it was more that I wasn't eating enough.

VJONES1985 Tue 31-Dec-13 10:07:53

Have you had the diabetes test yet? Ketones are common in diabetics.

juju283 Tue 31-Dec-13 10:23:24

I've had a blood test this morning to check. Won't receive the results until later on today though. I'm just so worried that Ive hurt the baby through it all.

juju283 Tue 31-Dec-13 10:23:50

I've had a blood test this morning to check. Won't receive the results until later on today though. I'm just so worried that Ive hurt the baby through it all.

VJONES1985 Tue 31-Dec-13 10:26:57

One way to flush them out is to drink loads, so make sure you're on the water.

I havr diabetes and a leaflet I've got here says ketoacidosis occurs when there is high sugar levels and not enough insulin, so the best tip I can give you is to avoid sugary foods and cut down on carbohydrates.

SliceOfLime Tue 31-Dec-13 10:27:23

Have you been very sick? Come and join the hyperemesis support thread if so - and also there are some ladies there who may know more about ketones. But definitely talk to your doctor, tell them what you've read and ask for more information, if there are real risks and if there's any way of knowing. Try not to feel bad and just keep asking questions!

TossedSaladsAndScrambledEggs Tue 31-Dec-13 10:28:22

You probably do need to eat more. Ketones normally happen when someone is following a very low calorie or lo carbohydrate diet. It is a sign that the body is burning fat rather than glucose for it's energy.

Are you eating enough or do you have bad morning sickness?

Ketones normally only occur in type 1 diabetes, when there is insufficient insulin to allow cells to take up glucose for energy.

Eat more, little and often, and foods containing slow release starchy carbs like brown rice/bread etc.

VJONES1985 Tue 31-Dec-13 10:29:12

Do you know how many ketones you had?

TossedSaladsAndScrambledEggs Tue 31-Dec-13 10:31:59

Less carbs are likely to increase ketones in someone who is not diabetic. Hence low carb dieters aim for a state of "ketosis".

It is the lack of insulin, rather than the high blood sugar that causes ketoacidosis. But of course as an aside the blood sugar will also be high if there is no insulin.

VJONES1985 Tue 31-Dec-13 10:32:38

What tossedsalads said is right but if you have diabetes (unlikely,I'm sure) you need to cut back on carbs until you're on insulin, to lower glucose levels.

If you aren't, then stick to eating starchy foods little and often.

VJONES1985 Tue 31-Dec-13 10:33:37

Sorry, cross posted.

juju283 Tue 31-Dec-13 10:40:21

When i had it tested at the hospital it was ++++ketones so quite high. When I test it myself it has gone down sometimes its clear but then occasionally trace or +1. I have been eating, I generally am not a big eater I never was before becoming pregnant either but I haven't beenskipping meals and i make sure I have carbohydrate with each meal. Neither Dr I've spoken too has been concerned but its just the scary stuff I've read.

VJONES1985 Tue 31-Dec-13 10:44:28

If you had loads (over 1.5mmol/l) then you would be nauseous or sick, feel tired or drowsy and that usually leads to losing consciousness so it's actually a good thing that you now seem to have less than 1.5. The symptoms of this first stage are increased weeing, tiredness and thirst.

TossedSaladsAndScrambledEggs Tue 31-Dec-13 11:21:34

I had +++ ketones in my urine during pg when I had noro virus and was vomiting and not eating.

They wouldn't let me go home til my ketones went down, but I think this was because it was in the context of me being unwell as well. They pumped me full of fluids but the ketones only went down once I stopped vomiting and was able to hold down food. Fluids may help remove the ketones from your body, but it is starvation/low calories that causes the ketones in the first place not the dehydration.

Ketones is what dieters aim for! It indicates your body is using more calories than it is taking in.

Had you had a busy day where you had been on your feet all day and not much time to eat?

I think if you try to eat more regularly it will be fine. Have you had your blood glucose taken with a finger prick test? If this was normal you should be fine, it is very unlikely you would have ketosis due to diabetes with a normal random blood sugar. The blood test you are waiting on is probably an hba1c, which will give an indication of what your blood sugar has been like over the last 6 weeks or so. Have they also done a glucose tolerance test?

TossedSaladsAndScrambledEggs Tue 31-Dec-13 11:23:22

Just as a disclaimer, dieters aim for ketones, but they should NOTbe aimed for in pregnancy! Just trying to point out that they are not always super harmful.

VJONES1985 Tue 31-Dec-13 11:27:46

I hope they have given you a finger prick test kit, which tests for both glucose and ketones (I have one so I know they exist). If you have already had a glucose test done, what was the result?

Xmas2013SantaB1610 Tue 31-Dec-13 11:28:11

I had ketones +++ in both pregnancies due to crap ante-natal care until I finally got "upgraded" to consultant led care.

Both my dc are on the G & T registers at school / identified as having higher learning potential or whatever label you want to put on their intelligence so I would just make sure you get your medical problem sorted such that you no longer have ketones +++ in your urine and stop worrying about your baby.

juju283 Tue 31-Dec-13 11:35:54

No glucose tolerance test. Just the blood test. I had a busy couple of weeks with christmas coming up. In my previous midwife appointment she found glucose in urine so told me to avoid sugar and I wasn't drinking very much at all which may have been the reason for such a high result. But Bit I still keep gettinunhow up now. I worry that it was ridiculously high for that whole two weeks though and am so scared that the fact I keep getting small amounts now that I've done damage to my baby. I havent got a clue how much to actually eat now because I thought it was enough but I don't want to stuff my face unncessarily.

juju283 Tue 31-Dec-13 11:36:38

No glucose tolerance test. Just the blood test. I had a busy couple of weeks with christmas coming up. In my previous midwife appointment she found glucose in urine so told me to avoid sugar and I wasn't drinking very much at all which may have been the reason for such a high result. But Bit I still keep gettinunhow up now. I worry that it was ridiculously high for that whole two weeks though and am so scared that the fact I keep getting small amounts now that I've done damage to my baby. I havent got a clue how much to actually eat now because I thought it was enough but I don't want to stuff my face unncessarily.

Rockchick1984 Tue 31-Dec-13 11:56:44

Try using My Fitness Pal to monitor your calories for a few days - ideally you need around 2000 cals per day during pregnancy. I use it occasionally as I'm very bad at controlling my eating, some days I only eat 500 cals, other days closer to 3000 so I like to try and track my average. If you're eating significantly less than the 2000 cals per day, or fairly low amounts of carbohydrate you will know you need to increase.

juju283 Tue 31-Dec-13 11:56:59

Xmas2013 at what point in your pregnancy did you get consultant care and did the presence of ketones go away completely. Were you diabetic? Did you have them right from the start?

Xmas2013SantaB1610 Tue 31-Dec-13 19:25:27

Juju283 I got consultant led care at about 8 weeks when I was admitted to hospital. I wasn't diabetic, nor did I develop Gestational Diabetes although did have to have a GTT much later in first pregnancy but suspect it was as a result of a urine test showing up the after effects of giving in to a sweet tooth phase.

As I understand it the ketones in the urine are because your body has gone into ketosis as a result of insufficient food (a natural result of vomiting back up pretty much everything you eat for some poor ladies) and is caused by the body burning through its own reserves to create energy instead of being able to rely on food intake to create energy although I was naturally also very dehydrated and didn't pee for several days.

I was never tested for ketones by GP/Midwife in my first pregnancy despite me describing my situation/symptoms in detail (hence my opinion re crap ante-natal care). I was tested on admission to hospital after waiting around for hours for a junior doctor to clerk & admit me, once the ketone results were known, whoosh, things started to happen quickly with treatment.

Second time around I asked my GP practice midwife (very politely) to check/measure ketones and was dismissed/ignored so I bought my own keto-stix and sure enough, needed admitting when I got to ketones +++. Why they wouldn't test for ketones taking into account my first pregnancy history is beyond me as it might have saved another emergency admission to hospital.

I felt well enough both times to abandon the keto-stix testing once I was discharged from hospital on medication so I can't say whether the + results continued at a low level.

BikeRunSki Tue 31-Dec-13 19:48:55

I had ++++ ketones for weeks and weeks in both pg due to hyperemisis. Spent most of that time on a drip in hospital. Both DC are fine.

Ilovekittyelise Tue 31-Dec-13 21:56:03

please dont cut down on carbs......the ketosis you are experiencing is FAR more likely as a result of fat metabolism due to not taking in enough calories; ie you are burning your own fat supplies (& dehydration also contributes).

diabetic ketosis (ketoacidosis) results from extremely high blood sugars and you would also have had a lot of glucose in your urine and strong symptoms of diabetes.

i have type 1 diabetes myself and NEVER had ketosis for "diabetic" reasons. i had traces a couple of times when id not eaten a great deal, and during my previous labour where i had ingested no carbs during a long period of time (& blood sugars were normal non diabetic levels).

cutting back on carbs is exactly what you dont need to do at this point, you need to keep hydrated and well fed;this is just so unlikely diabetes. even with gd you would not be spilling ketones unless it was wildly out ofcontrol in which case you would feel ill.

TossedSaladsAndScrambledEggs Wed 01-Jan-14 01:15:22

Absolutely agree with kitty. 3 good meals a day plus snacks will see you fine. How about porridge/muesli with fruit for breakfast, fruit ie. banana mid morning, sandwich for lunch with salad, snack mid afternoon, chilli and rice for dinner.

Plenty of healthy carbs there, and is hardly stuffing your face. Just eat til comfortably satisfied, and if you're hungry, eat something.

Lots of people tend to do the lean meat with salad/veggies thing for meals, but perhaps when pg, may be best to up the healthy carbs a bit. smile

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